NHS Sustainaibility and Transformation Plans

In the commons chamber on 14th September Peter Dowd MP took part in the debate on NHS Sustainability and Transformation plans. Peter’s speech is as follows:

A recent report to my local health and wellbeing board on STPs stated:

“There is a growing consensus that one of the most powerful ways to achieve change is through local services working together—across entire communities and pathways of care—to find ways to close the gaps between where we are now, and where we need to be in the future.”

That was the hope of the many people who have written to me on this matter. I really appreciate the time they have taken to share their concerns with me, but I can give them little comfort as things stand. Regrettably, in my area the “footprint” is an area in Cheshire and Merseyside, not in the Liverpool city region. That was determined unilaterally by the governance structure and it is regrettable, getting the process off to the wrong start, with the suggestions of local political leaders dismissed. That act has compounded the problem, in that they are the very people the NHS should be consulting: local communities, the leaders of councils and local councillors. These are the democratically elected representatives in those areas.

This move is all the more disappointing given that there is a council leader who has responsibility for the health and social care brief across the city region. It is more than disappointing—it is bizarre, especially as local government is supposed to be a significant partner of the NHS. The Government have pushed the issues of health and social care integration no end, but it seems more in theory than in practice. NHS England can hardly put out a press release without mentioning it, yet I suspect that many health footprints are in the same situation as those in my constituency. There is no doubt that people are being excluded. I have emphasised this issue because it goes to the heart of the willingness of the NHS to step out of its self-imposed bureaucratic mindset. Worryingly, though, it appears to have an almost pathological inability to break out of it.​

In my area, it is a case of going back to the past. The default position of my local NHS is to reinstate the old Cheshire and Merseyside health authority areas. My message is to stop and think. We are in the 21st century, not the 20th century. The reality is that the democratic lack of accountability in the NHS, certainly at a local level, leads to an inability to recognise that, in setting the terms of engagement with local community partners, it must do so before decisions are made, not after.

As far as I am concerned, the Government are telling us that all is well, that they have poured loads of money into the NHS and that there is enough in the system, so it is just a question of making better use of it. Yet the Germans spend 40% more per head than we do, and across the European Union the figure is 25%. People take the Government’s claims with a big pinch of salt, as all they see are waiting lists growing longer; ready access to their GPs becoming increasingly difficult; waiting times in A&E growing by the day; ongoing industrial disputes with junior doctors; and GP-led clinical commissioning groups beginning to start the process of rationing. And so it goes on. We need an NHS that has the consent of our community and an NHS that links in with communities. In this respect, I fear that the plans will turn out to be neither sustainable nor transformational, which will send the message that the NHS is not safe in Tory hands.